Volume : 3 | Issue : 3 | March 2014 ISSN - 2250-1991 Research Paper Medical Science

Incidence of Poisoning Cases in the Region of : Region Known For Farmer Suicide

Dr. Manish B. Prof & Head, Department of FMT, SVNGMC, Yavatmal Shrigiriwar Dr. Raviprakash D Assistant Professor, Department of FMT, SVNGMC, Yavatmal Meshram Dr. Sharad V. Assistant Professor, Department of FMT, SVNGMC, Yavatmal Kuchewar

Dr. Sachin J. Gadge Assistant Professor, Department of FMT, SVNGMC, Yavatmal

Hundreds of thousands of people are dying around the world each year from the effects of the use, or misuse, of pesticides. Poisoning represents large epidemic problem in the growth of developing countries in present era. One of the commonest mode of un-natural deaths all over the world are suicidal deaths and poisoning due to pesticide consumption remains the commonest, particularly in countries like and Sri Lanka. Sri Lanka has one of the highest rates of suicide in the world (29 Per 100,000 population in 1980). There is no strong law and guidelines for the sale and storage of pesticides, which is so commonly used in the farms in . The present study was conducted to evaluate the poison deaths in the Yavatmal region of Maharashtra. This study was conducted on the autopsy cases brought to the mortuary, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra. 2560 medico-legal autopsy were performed in the mortuary, ABSTRACT Shri Vasantrao Naik Government Medical College, Yavatmal, during the period from 1stNovember 2010 to 31stOctober 2013. Out of these 826 cases were suspected to have died of poisoning thereby constituting 32.26% of total un-natural deaths. Maximum cases were from 3rddecade of life and males outnumbered females. Data thus collected was analyzed statically.

KEYWORDS Pesticide, suicide, poisoning.

Introduction ton district in Maharashtra and Organophosphorus com- Every death represents a tragic waste of human life and re- pound pesticides are most commonly used. Also Organophos- sources, whether accidental, suicidal or homicidal. Death due phorus compounds are widely used for insecticidal purpose, to poisoning is no exception. It has increased gradually in the particularly in this Malwa belt, where cotton is a major last 8-12 years in India. WHO estimated that the worldwide crop(Gorea et al)3 incidence of acute pesticide intoxication has doubled dur- ing 1970s-1980s1. As per WHO, three million cases of acute Acute, deliberate self-poisoning with agricultural pesticides is poisoning with 2,20,000 deaths occur annually worldwide a global public health problem but reliable estimates of the in- particularly among agricultural workers. About 99% of these cidence are lacking. . Exposure to pesticides is usually suicidal deaths occur in developing countries. This figure could be just due to easy availability. When suicidal, it is termed as delib- the tip of the iceberg since most cases of poisoning actually erate self-harm (DSH), and results in a higher mortality than go unreported, especially in third world countries ( Gupta et when accidental. al)2. Ingestion of poison is a most common medical emergency in Pesticides are chemical compounds that are used to kill pests, Shri Vasantrao Naik Govt. Medical College, Yavatmal. In this including insects, rodents, fungi and unwanted plants (weeds). study the incidence of fatal poisonings in last three is demon- Pesticides are used in public health to kill vectors of disease, strated. such as mosquitoes, and in agriculture, to kill pests that dam- age crops. The increase in poisoning incidence can be blamed Material and Methods to the rapid in the field of science and technology and vast This study consisted of 826 autopsy cases brought to the growth in the industrial and agricultural areas. A number of morgue of ShriVasantraoNaik Govt. Medical College, Yavat- chemical substances, which were developed to save the agri- mal, during the period from 1stNovember 2010 to 31stOc- cultural products from rodents and various pests, so as to pro- tober 2013. Total 2560 medicolegal autopsy were performed tect the human beings from starvation, are in fact themselves during this period. The data was collected regarding age-sex becoming man – eater. Vector-borne diseases and those with and marital status from the police inquest and from the rel- intermediate hosts are among the major causes of illness and atives of deceased. All the data thus collected was analysed. death in many tropical and subtropical countries. Such diseas- es, which include malaria, , dengue, leishmaniasis, lymphatic Results filariasis , significantly impede economic and social develop- 2560 medicolegal autopsy were performed in the morgue of ment. A key to control these vectors is pesticides. Shri Vasantrao Naik Govt. Medical College, Yavatmal, during the period from 1stNovember 2010 to 31stOctober 2013. Out Maharashtra is a known for paddy, sugar cane and wheat of these 826 cases were suspected to have died from poison- crops. But Yavatmal is a district of cotton also known as cot- ing there by constituting 32.26% of total deaths.

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In our study 35.95% of total cases belongs to age group of cially in agricultural can be reduce by proper harvesting plan- 3rd decade followed by 18.64% to the 4th decade, 16.10% ning, technical expertise and loan facility at lowest interest to the 5th decade, 15.25% cases in 2nd decade and 0.84% rate as possible. cases in the first decade of life. 66.95% of total cases were males and 33.05% were females. 32.54% of the males and Social efforts like developing satisfactory interpersonal rela- 42.85% of females victims were in the age group of 3rd dec- tionship through proper counseling can check the high inci- ade. dence of poisoning in young and married population by the way of effectively tackling the social, marital and psychological In the present study shows that 69.85% cases were married problems. Involvement of NGO’s and voluntary organization in comparison with 30.15% cases which were un-married out should be enforced for community development. which the males (69.25%) and female (71.06%) were mar- ried. By bringing changes in framing practice – Integrated pest management and plant biotechnology. Discussion Direct restrictions of pesticide use – by pesticide restriction During this study 2560 medicolegal autopsy were performed programmes. in the morgue of Shri Vasantrao Naik Govt. Medical Col- lege, Yavatmal, during the period from 1stNovember 2010 Medical efforts: Poison information centers should be set up to 31stOctober 2013. Out of these 826 cases were suspect- along with first aid facilities and manpower provisions at PHC ed to have died from poisoning there by constituting 32.26% level, as immediate treatment can help in saving the lives in of total deaths. A study conducted by Dalal et al4 showed many cases. the percentage of poisoning cases to be 17.8% in 1994. It is no different from medicolegal deaths observed in same area during 1997-2001.5 this depict the In current study, more number of poisoning are due to socioeconomical reasons like monsoon-dependent cultivation practice, agriculture-based economy, crop failures, exorbitant rates of interest and indebt- edness to private usuries, financial crisis, increased work and labour pressure which lead to constant anxiety coupled with an easy availability of insecticidal poisons, as it is purchased and kept at forms and houses for use . The male : female ra- tio was 2:1. The finding were consistent with the study con- ducted by Jain et al5 in which the incidence of male victims was 69%. The study conducted by Behera et al 6 showed ratio of male –female victims was 2.7:1 consistent with the present study. Many other studies also showed similar trends like Singh et al8 – 2.7:1, Sharma and Bhullar7 – 3:1 and Mo- hanty et al9 – 2.9:1 as the ratio of male : female victims. The present study concurrence with other studies i.e Dash et al9 Figure 1 : Representation of poisoning (study victims) as found that 40.5% of cases belongs to 3rd decade, 21.6% cause of death to total death victims and related sex pro- in 4th decade, 20.9% in the 2nd decade. Similar trend was portion observed by Gupta and Vaghela9 which showed that 43.1% cases in the 3rd decade of life. The incidence of poisoning is Table 1 : Age & sex wise distribution of study victims decreasing on either sides reaching minimum incidence in the Male Female extremes of ages. This showed that most of victims were the Age in decades No. of No. of Total most productive age groups leading to loss of family income. cases % cases % 1st decade 4 0.72 3 1.09 7 70 % of victims were married which is in consistent with the 2nd 70 12.65 56 20.5 126 study conducted by Gupta et al2 in which 74.8% victims were decade married. A similar trends was also observed by Dhattarwal and 3rd decade 180 32.54 117 42.8 297 Dalal11 which showed that 66.6% victims were married. 4th decade 79 14.28 75 27.4 154 5th decade 122 22.06 11 4.02 133 Conclusion 6th decade 21 3.79 11 4.02 32 Poisoning accounts for 32.26% of total deaths i.e major cause 7th decade 63 11.39 0 0 63 of death in rural India Males outnumbered females with ra- 8th decade 14 2.53 0 0 14 tio being 2.0:1. Most of the victims (35.95%) belongs to 3rd Total 553 100 273 100 826 decade with minimum incidence in the extremes of the age i.e Table 2 : Marital status of study victims loss of earning member to family. Yavatmal region of Mahar- sex ashtra is therefore defamed for farmer suicide zone. Marital male female status Total No of % No of % Recommendations: cases cases Incidence of poisoning can be easily prevented by communi- 577 (69.8 Married 383 69.25 194 71.05 %) ty based strategies. New policies need to be introduced and 249 evaluated at regular interval. Un-married 170 30.75 79 28.95 (30.1%) 826 (100 A legal measure has to be made more stringent on account of Total 553 100 273 100 %) control of sales, distribution and storage. Financial crises so-

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